OK.. so now I am just totally confused! What to do??

Sigh.. well I thought I had this WLS thing figured out.... but now Im not so sure! LOL. I was set on having DS surgery with Dr Husted in Somerset. That was of course before I attended a seminar today with my fiance at Georgetown Bariatrics with Dr Tom. After meeting Dr Tom, I really really would like for him to perform my surgery, however, he does not perform the DS. He is such a doll! And so very very nice and professional! He was awsome! My fiance and I were both very impressed with him and his staff.
 
So either I get the DS with Dr Husted or I change over to the RNY Gastric Bypass with Dr Tom... there are just too many decisions! I go for my consult and all that on Wednesday with Dr Husted. Guess it looks like I have a big decision to make... grrrrr! Just venting cause Im all stressed out now. LOL

It's hard to know which route to go.  If you really like Dr. Tom and think he's a good surgeon, why not ask him why he doesn't do the DS procedure?  What are his reasons?  On the flip side, ask Dr. Husted why he doesn't do RNY (if he doesn't) or why he thinks the DS is better for you.  Tell them that you're having trouble deciding between the two and see what they say.  Do both doctors have similar experience? 

The doctor who is likely to do my surgery doesn't have the greatest bedside manner, but I think he's a very competent surgeon with a lot of experience.  I can handle his matter-of-fact personality because what matters most to me is his surgical expertise and the fact he's done so many of these procedures.

I wish you all the best as you make your decision.  Certainly, there are many success stories with both surgeries.  I don't think there's a "one size fits all" surgery.

Hi again Shea,

Dr. Tom is popular on this board, especially. He is a very talented surgeon but he is not skilled in the area of the Duodenal Switch.

Here is my take on the subject:
If you had your heart set on DS surgery, I wouldn't switch just to go with Dr. Tom for RNY. You wanted a DS, so don't switch for the surgeon alone. Many revision patients use the saying "Think twice, cut once." Check out the revisions board, you will see the majority of revision patients are Lap band and RNY patients. Check out www.dsfacts.com and you will see that Duodenal Switch surgery provides the best long term results. That is where many RNY patients start to struggle. Immediately post op and the 12-18 months after you cannot help BUT lose weight, the further you are out, the harder it becomes to maintain the loss. Make sure you check out the revision board, you will see this for yourself. Also with DS you keep your original stomach (though some is removed) and also pyloric valve. This will be useful as you won't have to worry about the man-made pouch, stoma issues (strictures or a stretched stoma), dumping, etc.

I just want to give you the info that I wish someone would've given me when I was pre-op. I am now almost 3 years post op RNY and have been looking into revision for the last 9 months or so. I don't have any insurance at the moment, so it's sort of at a standstill.

Hope this helps & If I can help you out any further please let me know
Katrina

Go with Dr. S
Two reasons
Since you have already begun at G-town you might as well finish. I have went to both Dr. Husteds and Dr. S info session and the one at G-town has a faster program. I am going with Dr. S in G-town despite the fact that I live in Somerset where Dr. Husted is set up.
Also the DS as I understood it was for the Super Morbidly Obese, like poor folks who weigh at 400-800 lbs. It doesnt look as though you would need something that drastic. Good luck with your decision. Plus your insurance might make the decision for you. Pray about it and God and the insurance co. will guide you.
Hugs
NCAirforcewife

"Also the DS as I understood it was for the Super Morbidly Obese, like poor folks who weigh at 400-800 lbs."


This is a common misconception about the Duodenal Switch surgery. I have researched my ass off on this topic and have spoken with several DS'ers about this. The guidelines for having a DS is the same as having Gastric Bypass.
http://www.duodenalswitch.com/faq/nih_guidelines/nih_guideli nes.html

It isn't a more drastic surgery, it can be customized depending on how much weight you need to lose. They can shorten or make your common channel longer depending on how much weight you have to lose.
Dr. Husted does a "hand count" of your intestines. Not many Duodenal Switch (if any) do this. Don't let the insurance company make up your mind, that played a big part in why I picked my RNY when I should have had DS. You do not want to be stuck with a surgery that the Insurance picks. I know for a fact Ky Medicaid covers DS and Dr. Husted is the only surgeon in KY that is qualified to perform Duodenal Switch.

Here is an interesting preliminary study you should take time to read Shea. It is a real eye opener.
http://nyp.org/news/hospital/884.html

You don't chose the surgeon first.  You research and decide which surgery to get, and then you find the best surgeon who does that surgery to do it for you.  You sure as [insert explitive here] don't chose a surgeon because "He is such a doll! And so very very nice and professional!" 

I don't need my surgeon to be my BFF, or my potential lover, or even someone who I would invite to a barbeque at my house.  He needs to have the BEST surgical skills, a reasonably competent office -- almost no matter how long his wait list is, and a decent aftercare program.  I would prefer if he takes my insurance, but as long as the hospital he works at takes my insurance, I'd rather pay more out of pocket for the best surgeon, not just the one who is willing to accept the crap payment that my insurance company is willing to pay.  I deserve at least better than that.

I have some relatively minor issues with Dr. Husted and his program.  However, if my own surgeon (who IS the best in the world) were not available, Dr. Husted would probably be my second choice.  His surgical skills are top notch, and he is a very caring surgeon (which is almost an oxymoron).  You have no idea how lucky you are to have him available to you.


"Also the DS as I understood it was for the Super Morbidly Obese, like poor folks who weigh at 400-800 lbs."

This is so untrue that I am almost sputteringly at a loss for words, which is saying something for someone who is a scientist and an attorney.  "Sharing" this kind of disinformation is very troubling to me.

While there is no doubt in the WORLD that the DS is superior to any other surgery in %EWL and most importantly maintenance long-term of the highest %EWL for supermorbidly obese (those with a BMI >50), nevertheless it also has the best statistics for those with BMIs who are lower (not as strikingly better, because some with BMIs under 50 can manage, with strict adherence to diet and excercise programs for the rest of their lives, to keep a reasonable %EWL with other surgeries).

The vast majority of people who get the DS have BMIs under 50.  The vast majority of people with BMIs over 50 shouldn't consider any other surgery.  There is a big difference in those two statements -- don't confuse them.  The vast majority of people who get the DS are very happy campers, myself included.

Thanks to everyone's comments. A special thanks to Katrina for her wonderful info. I have decided to stay with Dr Husted and have the DS procedure. Its just my gut feeling. I feel this surgery would be best for me. I go for my consult/nut/group meeting/psych on Wednesday morning. Im so excited to get this process started! Yay!
My fiance is staying with Dr Tom in Georgetown. We are sending in his insurance packet and info tomorrow.